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REMARKS BY: DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE:		Jane Roberts Lecture, University of  Miami, Miami, Florida
DATE:		November 16, 1998

As I prepared to come to Miami to give this lecture for the Women's Studies Program, I realized that one of the nation's leading authorities on the status of women is right here in your own backyard. I'm talking about the Miami Herald columnist, Dave Barry. You have to respect a man who says, "I believe that, in general, women are saner than men." Actually, Dave thinks he's got it all figured out. He says if women were in charge of the country, there would be no words in our vocabulary like "wedgie." If women were in charge of the country, there also would be no such sport as professional lawn mower racing. And if women were in charge of all the world's nations, he believes there would be virtually no military conflicts. But if there were a military conflict, everybody would feel just awful about it. There would soon be a high-level exchange of thoughtful notes. They would be written on greeting cards with flowers on the front. And finally, there would be a Peace Luncheon. Which would be salads -- with the dressing on the side.

Dave Barry is just pretending to be clueless. Because in fact, we all know what really happens when women take charge. Jane Roberts showed us. Justice happens. Equality happens. Unity happens. Good things happen for children, women, minorities, families -- and their communities.

I'm honored to give the Jane Roberts Lecture this year, because this year marks an important milestone in women's history. It's the 150th anniversary of the birth of the women's movement at Seneca Falls, New York. It was in the summer of 1849 that women traveled from all over the country to that small town to sign the Declaration of Sentiments. In that document, women added two words to the most hallowed phrase in our history. They declared that, "All men -- and women -- are created equal."

Today -- a century and a half later -- the voice of women is still the voice of progress. The voice of families and children. The voice of America. And, the voice of leadership. Every year we put more women in the state capitals. More women in Congress. More women in the courts. More women in health care careers. More women in corporate leadership. And there are more women in the President's Cabinet than ever before. Frankly it's gotten pretty crowded in the women's bathroom at the White House. Picture this after a cabinet meeting -- there's Madeleine Albright, Janet Reno, Alexis Herman, Carol Browner, Aida Alvarez, Janet Yellen, Charlene Barshefsky and me.

These women have been busy. With the support of the President, we have reordered the nation's priorities, and reshaped the national agenda. We have rewritten the definition of "national security" -- recognizing the importance of family issues, from the kitchen table to the national stage. And, we are realizing the real needs of women, children and families. Together, I believe we have changed America for the better. From my perspective, there is one area where I'm particularly proud of our progress for women.

I'm talking about women's health. A subject that has put the University of Miami on the map for being one the sites for the Women's Health Initiative sponsored by the National Institutes of Health.

Today, it seems like everybody's talking about women's health. It's on the front pages and the magazine racks. On radio talk shows and TV news programs. On Sally, Rosie and Oprah. You even have a member of the President's Cabinet wearing a milk mustache, urging women to fight osteoporosis. But women's health hasn't always been popular. There was a time -- not long ago -- when women's health was a lowly footnote in the annals of public health. A time before Our Bodies, Our Selves was on all of our shelves. It was a time when publishers would never print a diagram of a breast, or a map of the woman's reproductive system. And it was a time when women simply suffered in silence. When pre-natal care was little more than a pat on the stomach. When the term "breast cancer survivor" was an oxymoron. When a girl suffering from bulimia would get a compliment for "looking great" instead of the help she was crying out for. It was a time when a battered woman would rather say she'd walked into a door than run into the stigma of domestic violence. And we all remember a time when cigarette billboards first tried to tell us that women's rights included the right to die from lung cancer. When I see those ads with a cigarette dangling from a woman's mouth, I think, "you've come the wrong way, baby."

Those were the days when women's health was largely ignored, in spite of several inescapable facts. Fact: The health of every developing child is directly related to the health of his or her mother. Fact: Most families depend on Mom being healthy every day. Fact: Women by and large make the health decisions for their families -- children, spouses and even aging parents. For too long, diseases that ail and kill so many women were considered a tragedy and a shame -- but never treated as a crisis or a priority.

Women wondered why our diseases were just our diseases -- and not the concern of everyone. It was like the woman who was pondering the nature of God. She put her hands together, looked to the heavens and asked, "God, how long is a million years to you?" God answered: "A million years is like a minute." Then the woman asked: "God, how much is a million dollars to you?" And God replied: "A million dollars is like a penny." Finally the woman asked: "God, could you give me a penny?" And God said, "In a minute."

It seems like we've been waiting a million years for women's health to become a national priority. But then we stopped sitting in the waiting room. And we started demanding action and taking action. It took revolutionary thinking, from the Popular Reform Movement of the 1830s, which urged women to stop wearing corsets, to Roe versus Wade, which upheld our reproductive rights. Our progress took revolutionary women, from Margaret Sanger and her path-breaking birth control clinic in Brooklyn, to Jane Roberts and her devotion to the Rape Crisis Treatment Center at Jackson Memorial. Our progress took mobilization, from women's groups to key legislators, scientists, journalists and public health institutions, both government and private. It also took activism, from the `70s protest demanding that Congress hold hearings on the safety of The Pill, to the petition drive in 1993 demanding a national response to breast cancer. Finally, our progress took leadership. And I'm proud to say, in all my years in public policy, I've never seen a White House more committed to women's health -- in words, deeds and achievements.

I'm proud to be part of these achievements. We've defended women's reproductive health and rights. We've reduced teen pregnancy. We've stopped drive-by childbirth deliveries. We've stepped up the fight against HIV/AIDS. And we've pressed American food makers to add folic acid to many foods to reduce the risk of birth defects. And thanks to research institutions like the University of Miami, our Women's Health Initiative is uncovering the major causes of death, disability and frailty in older women. As the Gateway to the Americas and a beautiful mosaic of diverse people, Miami is the perfect place to conduct clinical trials for a wide range of women.

In the past six years, we've also advanced one of Jane Roberts' causes by defining violence against women as a public health crisis -- and taken action to stop it. We've set up a national crisis hotline, tripled funding for battered women's shelters, hardened penalties for abusers, strengthened training for police, prosecutors and judges, and reached out to health care professionals to help us protect women and detect abuse. And two weeks ago, Vice President Gore announced that women who've suffered domestic violence can apply for a new Social Security number to prevent their abusers from tracking them down. It was a small step for Social Security. But a giant leap for personal security.

Let me also take this opportunity to announce that our National Women's Health Information Center is now up and running. A hundred years ago, Virginia Woolf suggested that all a woman needed to be a writer was "money and a room of her own." Today, thanks to our new Website and telephone hot-line, all a woman needs to get quick, trustworthy health information is a computer or a telephone. [www.4women.gov; 1-800-994-woman]

But perhaps our greatest advance for women's health is in our battle against breast cancer. We've unleashed every weapon in our arsenal. First, research -- we've isolated the genes linked to many cases of breast cancer. Second, privacy -- we stopped many health plans from using a genetic predisposition to breast cancer to deny or price coverage. Third, prevention -- we've clarified and promoted the use of mammograms, set mammography quality standards and made them free or low-cost to older and low- income women. Finally, money -- we doubled the funds devoted to breast cancer research and programs, bringing the total to a half-billion dollars in 1998. But next year's budget against breast cancer breaks all records, with nearly 400 million new dollars for the National Cancer Institute. Now NCI will be able to fund critical new breast cancer research. We're launching several clinical trials to treat breast cancer, including whether to expand the use of Herceptin to treat breast cancer earlier. And pending FDA approval, we'll launch the largest breast cancer clinical trial in history -- 20,000 women at 400 sites -- to see whether Tamoxifen and Raloxifene can protect post-menopausal women who are at a higher risk of breast cancer, but have not had the disease. We're determined to rock breast cancer back on its heels, to speed the day when there are no breast cancer statistics -- only survivors.

Looking back on our progress on women's health, we've reached a lot of important milestones. But we still have miles to go. When it comes to defending our health, women's work is never done. And the work we've done often is in danger of being undone.

Right now the Library of Congress in Washington is hosting an exhibit on Sigmund Freud. We all know it was Freud who said, "What do woman want?" Well, I think even Freud would understand the message we sent in the `98 elections: Women want Congress to get back to business. We want Congress to stop trying to chip away at our rights. We want Congress to advance our rights. To lead, follow or get out of the way. And we want Congress to stand up, step up and take up the real needs of women, children and families today.

In my opinion, the test for the new Congress boils down to whether it deals honestly with four issues that are critical to women.

First, Congress must save Social Security. Social Security is crucial to women. Women retire with far less retirement income, smaller pensions and less savings. Women live longer. And older women face poverty at alarming rates. For many women, Social Security means financial security. Older unmarried women get half their income from Social Security. For one-quarter of these women, a Social Security check is their only income. So before Congress spends down the federal surplus, it must think about our mothers and grandmothers, and put Social Security first.

Secondly, Congress must help protect our children from the number-one preventable cause of disease and death -- tobacco. Every day, more than 3,000 young people become regular smokers. Some day, 1,000 of them will die from tobacco-related illness. More of these deaths are likely to be among women, because smoking among girls is catching up to boys. According to our most recent survey, more than a third of high school girls reported using tobacco. For different reasons than boys. Cigarette ads and popular culture tell girls that smoking will make them thin, glamorous, cool and successful. That smoking Is "a woman thing." And they believe it. We know what it takes to change their minds. But the questi on is, what will it take for Congress to take action?

Women also want to know if Congress will help relieve our child care headaches. Today, three out of five mothers with children under 6 work outside the home. At least 5 million school-aged children are left unsupervised during those critical after-school hours. When you talk to mothers who need child care, their concerns usually boil down to three important questions: Can I get it? Can I afford it? Can I trust it? This year, Congress failed to act on the President's Child Care Initiative, a package of measures to help working parents find and afford child care they can trust. But we're not giving up. When the new Congress convenes next year, we will pursue bipartisan solutions to parents' child care headaches.

The fourth burning question facing Congress next year brings us right back to women's health: quality and access in the health care system.

Health care is the number-one kitchen table issue for many women. Women make more than 60 percent of physician visits. I mentioned earlier that women make most of the health care decisions for their families. And women have greater need for specialty services such as obstetrics and gynecology.

Our country has the best health care system in the world. But not for every woman, all the time. Especially for women without health insurance. It's simply untenable that 43 million Americans are uninsured today. That's six million more than four years ago, when the President put the problem on the national table. Too many of the uninsured are women. And it's getting worse. Over the last two years, more than 1 million girls and women joined the ranks of the uninsured -- bringing the number to 20 million altogether. The troubling thing is that most of them are not poor women. 62 percent are above the poverty line. Many include the so-called "Waitress Moms" -- mothers working one or two low-wage jobs, stretching to pay for rent, food and child care. For them, health insurance is an extra, a luxury they can't afford.

We're helping many low-income mothers with our Children's Health Insurance Program -- known as CHIP. CHIP will cover 5 million uninsured children -- nearly 175,000 children over the next few years in Florida alone. But too many people are still uninsured. I want to work with Congress to find ways for the most vulnerable people to participate in existing health care programs -- public and private.

For people who do have health insurance, Congress knows it cannot ignore the demand for patients' rights and quality. Patients' rights in managed care is crucial for women. Too many women worry they'll be denied specialty care or a medical procedure when they need it. Women have a right to access to qualified specialists like OB/GYNs for routine and preventive services. Pregnant women should have a right to continuity of care, even if their health plan drops their doctor. All women should have a right to recourse if they are maimed or injured after her health plan overruled her doctor. If the health care system will not guarantee these rights, women have a right to expect Washington to take action.

This coming year, the President once again will challenge Congress to adopt a Patients' Bill of Rights for all Americans in private health plans. The question is whether Congress will pass a real cure, or a placebo. There's a simple way to tell the difference. The real thing will give every woman the access and quality guarantees that every member of Congress enjoys today.

Women have come a long way since we took off our corsets, read Our Bodies, Ourselves, and put women's health on prime time. Now the battle we face is access to quality health care. And I know we'll win. We always do. Because revolutionary women from Lizzy Stanton to Jane Roberts never stop fighting. In an interview with the Miami Herald, Jane talked about her work with her church, St. Philip's Episcopal, here in Coral Gables. But she quickly added -- "I don't go every Sunday. Don't get the wrong impression." Dave Barry has the wrong impression of women when he suggests we're opposed to conflict. Because if the need is great, the cause is just and the time is right, we relish a fight -- and we fight to the finish. And when it comes to women's health, there has never been a better time to fight then when we're ahead -- and that's right now. Thank you.